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This document outlines the assurances given by a contractor regarding the protection of personal health information in compliance with HIPAA, HITECH, and the State Administrative Manual.
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How to fill out Statement of Assurances for Protection of Personal Information

01
Begin by downloading the Statement of Assurances for Protection of Personal Information template from the relevant authority's website.
02
Read the instructions provided at the beginning of the document to understand the requirements.
03
Fill in your organization's name, address, and contact information in the designated sections.
04
Provide a brief overview of your organization's data protection policies and practices.
05
List the types of personal information you collect and how it is used.
06
Detail the procedures for safeguarding personal information, including physical and electronic security measures.
07
Include information about staff training and awareness programs on data protection.
08
Sign and date the completed form in the designated area, ensuring proper authorization from management.
09
Submit the completed Statement of Assurances as per the guidelines outlined by the authority.

Who needs Statement of Assurances for Protection of Personal Information?

01
Organizations that collect, store, or process personal information of individuals.
02
Educational institutions handling student data.
03
Healthcare providers managing patient information.
04
Businesses operating under regulations that mandate data protection assurances.
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Sensitive personal information includes: Social security or passport number, driver's license, or state ID. Financial account credentials. A consumer's precise geolocation.
Sensitive personal information includes: Social security or passport number, driver's license, or state ID. Financial account credentials.
Protect yourself online Always be alert to your online safety when using websites and apps. For example, avoid using unsecured wi-fi networks for secure transactions, like banking or online shopping. Use different passwords for different accounts, make sure you choose strong passwords and change them regularly.
Anyone responsible for using personal data must make sure the information is: used fairly, lawfully and transparently. used for specified, explicit purposes. used in a way that is adequate, relevant and limited to only what is necessary. accurate and, where necessary, kept up to date. kept for no longer than is necessary.
Pay particular attention to how you keep personally identifying information: Social Security numbers, credit card or financial information, and other sensitive data. That's what thieves use most often to commit fraud or identity theft.

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The Statement of Assurances for Protection of Personal Information is a document that outlines the measures taken by an organization to safeguard personal information and ensure compliance with privacy laws and regulations.
Organizations that handle personal information, particularly those that are subject to data protection laws, are required to file the Statement of Assurances for Protection of Personal Information.
To fill out the Statement of Assurances, an organization must gather information about its data protection practices, complete the relevant sections of the form, and ensure that all statements are accurate and reflective of their actual practices.
The purpose of the Statement of Assurances is to demonstrate an organization's commitment to protecting personal information, to assure stakeholders of their data security measures, and to comply with applicable privacy regulations.
The Statement of Assurances must report details about data handling practices, security measures in place, compliance with privacy laws, and any other relevant information that reflects the organization's approach to protecting personal information.
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